29. Testosterone Optimization Therapy
29. Testosterone Optimization Therapy
CATEGORY: Anabolic Steroids 100 Courses
COURSE NUMBER: 29
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Introduction: The Unapologetic Truth About Testosterone
Chapter 1 – Why are Men Losing Their Masculinity In The 21st Century?
What this Book Is
What this Book is Not
Chapter 2 – Why Optimizing Your Blood Testosterone Levels Will Transform your Physique
Testosterone Decreases Body Fat
Testosterone Increases Muscle Mass
Testosterone Improves Heart Health
Testosterone and the Brain
Testosterone and Dopamine
Testosterone and Depression
Testosterone and Memory
Testosterone Combats Alzheimer’s Disease and Improves Cognition
Testosterone Prevents Osteoporosis and Frailty
Testosterone Fights Inflammation
Chapter 3 – The Power of Testosterone to Transform Your Life
Testosterone and the Manifestation of Will
Testosterone will Improve Your Sexual Confidence with Partners
More Testosterone Equals Heightened Sex Drive and Libido
The Competitive Edge Gained From Using Testosterone
Testosterone Helps You Take Risks And Achieve Higher Social Status
Optimal Testosterone Levels Lead to Your Most Powerful and Enlightened Self
Chapter 4 -The Natural Testosterone Boosting Myth
Zinc Magnesium Aspartate (ZMA)
The Only Proven Way to Raise Testosterone
Raise Libido, Raise Testosterone?
Chapter 5 – Testosterone 101: Understanding the Biological Role of Testosterone
What is Testosterone and How is It Made?
Why Do Men Stop Producing Optimal Levels of Testosterone?
Endocrine Disruption from Modern Day Societal Living
Chapter 6 – Choosing When to Optimize Your Testosterone Levels
Is There an Ethical Dilemma in Choosing to Use Testosterone?
Testosterone Levels Decline with Age
Symptoms of Low Testosterone
ADAM (Androgen Deficiency in Aging Males) & AMS (Aging Males Symptoms)
Know Your Testosterone Levels, Understand Your Test Results
The Normal Range Fallacy
Vital Life Markers Necessary for TOT
How to Get Tested for Low Testosterone
Chapter 7 – Testosterone Optimization Therapy – Non Injectable Options
Creams and Gels
Natesto Nasal Gel
Oral Forms of Testosterone
Chapter 8 – The Optimal TOT Protocol: Injectable Testosterone
Testosterone Cypionate and Testosterone Enanthate
Our Recommended TOT Protocols
The FDA and Testosterone Therapy
Choosing the Right TOT-Prescribing Physician
Vetting Your TOT Doctor
The Costs of TOT
Chapter 9 – How To Properly and Safely Inject Yourself for Life
Syringe, Needle Gauge, and Withdrawing
Where To Inject The Needle, and How to Inject Yourself Safely
TOT Via Subcutaneous Administration
Minimizing Scar Tissue Formation with Foam Rolling and Myofascial Release
Chapter 10 – Potential Side Effects, Their Likelihood, and How to Alleviate Them
Baldness and Acne
SERM’s (Selective Estrogen Receptor Modulators) and AIs (Aromatase Inhibitors) to Treat Side
The Usage of AIs and SERM’s as TOT
Metabolic Syndrome, Obesity, Insulin Resistance, Aromatase and Estrogen
Chapter 11 – Eliminating Gynecomastia Permanently
Types of Gynecomastia
Option 1 – Conceal/Avoid
Option 2 – Lose Fat, Build Muscle, & Balance Hormones through TOT
Option 3 – Surgical Removal
Chapter 12 – Monitoring TOT for Optimum Health
Understanding Your Blood Panels
BioMarker Cheat Sheet
Evaluating Blood Testosterone
The Importance of Sex Hormone Binding Globulin (SHBG)
Hematocrit and Hemoglobin
PSA (Prostate-Specific Antigen) & Prostate Health
Sleep Apnea and TOT
Heart and Vascular Health
Lipids (Blood Fats) and Cholesterol Health
Testicular Shrinkage, Low Sperm Count and HPTA/HPGA Dysfunction
The Myth of Penis Shrinking
Why Cycling Testosterone is a Myth
Chapter 13 – The Critical Role of Nutrition in TOT
Your Caloric Intake is Dependent on Your Physical Goals
The Specific Macronutrients Needed on Your TOT Nutrition Plan
Vitamin & Mineral Supplementation to Maximize TOT
What to Minimize and Avoid While on TOT
Proper Hydration – How Much Water is Enough?
The Importance of Vitamin D from Sunlight and Supplementation
Chapter 14 – What is Insulin-Controlled Living, and Why Is it Essential?
How Insulin Works
Insulin and Glucose Utilization
Major Myth of “Insulin Hypothesis”
How Do You Manage Your Insulin?
Good Carbs vs Bad Carbs
Optimal Versus Suboptimal Carbohydrate Consumption
Overall Plan of Attack
Chapter 15 – Agents of Change
Energy Memory Focus (EMF) (OTC Nootropic)
Human Growth Hormone (HGH)
Ipamorelin for Women
Melanotan I and Melanotan II
Future Agents of Change
Chapter 16 – TOT and Fitness
The Foundational Role of Weight Training
Building Muscle and Strength
The Cardio Equation – How Much and What Kind?
The Importance of Sleep
Dealing with Injuries
Bonus Chapter 17 -The State of the Science in Male Hormonal Optimization: Interview with Dr.
Bonus Chapter 18 – Hormonal Optimization Therapy (HOT) for Women: Doing it the Right Way
Female Health is Neglected
Hormone Deficiencies are a Disease at Any Age
Hormone Deficiencies are a Health Priority
Birth Control is NOT Hormone Restoration:
Pre- and Perimenopause
Key Principles in Female Hormone Optimization Therapy (HOT)
Applying the Key Principles
Bonus Chapter 19 – The Stone Cold Truth about Anabolic and Androgenic Steroids (AAS)
Don’t Ask About Steroids Until You Understand Steroids
A Brief Mention of AAS Drugs (Most Popular Synthetics)
Do Anabolic Steroids Work?
The Biological Differences Between Testosterone in Men and Women
Does TOT Count As Steroids?
Difference Between TOT and AAS
Potential Negative Side Effects
The Effects of AAS on Mood
What About the Increased Strength and Size?
How Much Expected Muscle Gain?
The Downside to Taking Steroids
Putting Pro Bodybuilding History Into Perspective
Bonus Chapter 20 – TOT and US Military Veterans: The Problem and Solution
Tales From the Blast Factory: A Veteran’s Story
Testosterone and the Road to Recovery
Looking After Our Veterans
Out with the Old and In with the New
Chapter 21 – Conclusion
The Golden Rules
Frequently Asked Questions
About the Authors
The Science Team
The Editing Team
A Sincere Request
Testosterone Optimization Therapy
Testosterone replacement therapy (TRT) has surged in popularity over the past decade. Millions of older men have turned to TRT to restore hormone levels in hopes of refueling energy and reigniting their sex drive.
Yet TRT remains controversial because of its uncertain benefits and potential health risks. Safety concerns were raised years ago when studies showed a possible association between TRT and an increased risk of cardiovascular disease.
Dr. Frances Hayes, a reproductive endocrinologist with Harvard-affiliated Massachusetts General Hospital, points out that some of these studies had limitations.
“For instance, in one study, TRT doses were much higher than what would usually be prescribed, and the subjects tended to be more frail, with other health problems,” she says. “Other studies showed no evidence of increased risk.”
The latest findings
Recent research has supported this position. A study reported at the 2015 American Heart Association Scientific Sessions involved 1,472 men ages 52 to 63 with low testosterone levels and no history of heart disease. Researchers found that healthy men who received TRT did not have a higher risk of heart attack, stroke, or death.
Furthermore, a study in the August 2015 Mayo Clinic Proceedings showed no link between TRT and blood clots in veins among 30,000 men. “Right now, the jury is still out about TRT’s influence on cardiovascular disease,” says Dr. Hayes.
TRT’s relationship with other health issues is also mixed. For instance, TRT has previously been tied to a higher incidence of prostate cancer, but a study published in the December 2015 Journal of Urology found that exposure to TRT over a five-year period was not linked to a greater risk of aggressive prostate cancer.
The bottom line is that the long-term risks of TRT are still unknown, as many of these studies have limited follow-ups. That does not mean you should avoid TRT. For a selected subgroup of men, the therapy can be a viable option.
Who is a candidate?
You need to have both low levels of testosterone—less than 300 nanograms per deciliter (ng/dL)—and several symptoms (see page 7) to get a prescription for TRT. “It is possible to have low levels and not experience symptoms,” says Dr. Hayes. “But if you do not have any of the key symptoms, especially fatigue and sexual dysfunction, which are the most common, it is not recommended you go on TRT given the current uncertainty with regard to long-term safety.”
A simple blood test measures testosterone levels. Several tests are required, as levels can fluctuate daily and be influenced by medication and diet. “In 30% of cases where the first testosterone test is low, levels are normal when the test is repeated,” says Dr. Hayes.
Even if your levels are low and you have several symptoms, TRT is not always the first course of action. “If you can identify the source for declining levels, often you can address that problem and increase low levels naturally,” says Dr. Hayes.
For instance, the No. 1 contributor to falling levels is weight gain. “Weight has a bigger impact on testosterone levels than aging. As weight goes up, testosterone levels go down,” she says. A five-point increase on the body mass index scale—for instance, going from 30 to 35—is equivalent to adding 10 years to your age in terms of testosterone levels.
“Your doctor should also review any other factors that might influence levels, like medication or medical conditions,” says Dr. Hayes. In these instances, your doctor may treat the underlying condition or change your medication or dosage to one that would not affect testosterone levels.
Men also need to understand the limits of TRT, as many envision it as a type of fountain of youth. “Its impact is less than what many men would expect,” says Dr. Hayes.
For example, two often-touted benefits of TRT are sexual health and vitality. A double-blind study in the Feb. 18, 2016 issue of The New England Journal of Medicine reviewed the effects of TRT on 790 men ages 65 and older. Those who received TRT for one year, versus those on placebo, saw improvements in sexual function, including activity, desire, and erectile function. However, the group experienced only a slight improvement in mood and saw no changes in walking speed, which was used to measure TRT’s effect on vitality.
TRT is often given by either gel application or injection. With a gel, you spread the daily dose—often the size of a ketchup package—over both upper arms, shoulders, or thighs. Injections are typically given into the buttocks once every two weeks.
Each method has its advantages. With gels, there is less variability in levels of testosterone. “However, you have to be careful to avoid close skin contact for a few hours, especially with women, as the testosterone could cause acne or hair growth,” says Dr. Hayes.
With injections, testosterone levels can rise to high levels for a few days after the injection and then slowly come down. This can cause a roller-coaster effect, where mood and energy levels spike before trailing off.
Most men feel improvement in symptoms within four to six weeks, although changes like increases in muscle mass may take from three to six months.
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